Chapter 9: Substance Abuse and Cancer

THE SUBSTANCE ALCOHOL

Alcohol is widely used in our society. Most individuals who use alcohol drink in ways that do not increase risk of alcohol use problems. Some, however, drink in ways or at times during their life course that increase risk to themselves or others. Still others who use alcohol may derive a health benefit from its use.¹

According to Nels Ericson at the US Department of Justice,² "research has long shown that the abuse of alcohol, tobacco, and illicit drugs is the single most serious health problem in the United States, straining the health care system, burdening the economy, and contributing to the health problems and death of millions of Americans every year. Today, substance abuse causes more deaths, illnesses, and disabilities than any other preventable health condition." He states that substance abuse is the nation's number one preventable health problem. The economic costs of drug and alcohol abuse in the United States are estimated to exceed $275 billion per year; this includes lost productivity, medical expenses, crime, and other costs. More than 22 million people are in need of addiction treatment according to the Robert Woods Johnson Foundation Knowledge Asset Policy Brief³ dated September 2008.

Alcohol's causal link to cancer has been known for decades.^4,5 The continued use of substances has a known adverse effect on human immune function. Alcohol is the favorite mood-altering drug in the United States. Its effects, both pleasant and unpleasant, are well known. What is not as well known is that alcohol is a toxic drug that produces pathological changes in tissue and organs and can cause death. A recent report from the Substance Abuse and Mental Health Services Administration shows a small percentage of people are kicking smoking while alcohol- and illicit drug–use levels remain steady. Alcohol still leads tobacco as the most commonly used substance. Marijuana is the most commonly used illicit drug. The rate of illicit drug use in 2007 among persons aged 12 or older was 8% to 10% in the general population in the United States. The illicit drugs include hallucinogens (including Ecstasy), cocaine, methamphetamines, and prescription drugs. More information on distribution of drug and alcohol use by state can be found at www.nida.nig.gov.

ALCOHOL LINKS TO CERTAIN CANCERS

In 2000, the National Toxicology Program Report to the US Department of Health and Human Services¹ listed ethyl alcohol as a human carcinogen for the first time. Consumption of alcoholic beverages is causally related to cancers of the mouth, pharynx, larynx, and esophagus. Cohort and case–control studies consistently find moderate to strong associations between alcohol consumption and those cancers. Evidence also supports a weaker but possibly causal relationship between alcohol consumption and increased risk of cancers of the breast and liver. Epidemiologic research has demonstrated a dose-dependent association between alcohol consumption and certain types of cancer; as alcohol ...